Jugular Venous Catheterization: A Case of Knotting

Spontaneous Knot Formation in a Central Venous Catheter

Patient: Male, 63-year-old

Final Diagnosis: Spontaneous knot formation in central venous catheter

Symptoms: Central venous catheter whit any flow • associated with pain at the insertion site of the access

Medication: —

Clinical Procedure: Central venous catheterization

Specialty: General and Internal Medicine • Surgery

Malfunction of a central venous multilumen access catheter caused by kinking: A case report

RATIONALE

A multilumen access catheter (MAC) is a large-bore catheter that prevents kinking or collapsing. Misplacement is a frequently reported complication.

PATIENT CONCERNS

A 59-year-old man who was diagnosed with a hemoperitoneum due to a liver laceration after a fall.

DIAGNOSIS

After catheterization, we were able to aspirate blood through the 9 Fr, but not the 12-gauge line. Thus, we assumed that the catheter was misplaced. Nevertheless, ultrasonographic findings did not reveal the reason for the malfunction. We found kinking in the distal part of the catheter after removing it.

INTERVENTION

The MAC was removed soon after stopping the active bleeding.

OUTCOMES

A hemihepatectomy was successfully performed, and the patient was transferred to the intensive care unit.

LESSONS

Anesthesiologists should consider kinking of large-bore catheters, including MACs.